🚀 Launching a new series for interns, residents, and hospitalists:. 🎗️ Oncology for The Non-Oncologist Tuesdays 🎗️.🩸 Hematology for The Non-Hematologist Thursdays 🩸. My previous PD used to say “Heme/Onc is like practicing medicine on Mars.”. My goal? .Take you to Mars, and.

What no one tells you is that medicine isn’t about answers. It’s about managing the weight of questions.

Wait, before you clock out for the day . why don’t you learn thrombocytopenia on the go? Link below 👇🏻.

RT @hsafaMD: 🩸Hematology for The Non-Hematologist🩸. (An educational series for internal medicine trainees and physicians, aiming to make he….

RT @dr_PrakhyathS: @hsafaMD Submitted my application for Heme/Onc fellowship. Grateful beyond words to my mentors, program and friends whos….

Do you to learn more about how to approach an incidental mass? Link below 👇🏻.

If you found this helpful, like and repost so it reaches the next person caught off guard. And stay tuned for episode 4 next week. Next heme Thursday: What exactly is Neutropenic fever?.

16/ Bottom line:. 1.Confirm thrombocytopenia is real.2.Assess bleeding risk / clinical urgency.3.Send primary labs + smear.4.Think production vs. destruction vs. sequestration.5.Look for red flags (TTP, HIT, DIC, leukemia).6.Know when to call Heme.7.Know when (and when not) to.

Stay tuned. I’ll post a full discussion of the case presented earlier in the thread, including the correct answer and key teaching points.

15/ Bonus post:. Less Common, But Don’t Miss:. Not every thrombosis-related thrombocytopenia is HIT or DIC. Keep these in mind:. – Trousseau Syndrome.Cancer-driven hypercoagulability causing recurrent or migratory clots. Platelets may be normal or mildly low due to ongoing.

14/ What about in ITP?. In ITP (Immune Thrombocytopenia), transfusing platelets is generally avoided unless absolutely necessary. Why? Because the underlying issue is immune-mediated platelet destruction, so transfused platelets are rapidly cleared. Here’s a simple, practical.

13/ When (and when NOT) to transfuse platelets. Generally speaking. – <10K → transfuse even without bleeding (prophylactic).- < 20k → if febrile (soft call).– <50K → if active bleeding or before major procedures (check with surgery team).– <100K → transfuse before.

12/ When should you call Hematology urgently for thrombocytopenia? Cont’d. – Smear shows blasts or pancytopenia.Consider leukemia or marrow failure. → Early Heme input for workup and transfusion planning. → Treatment targets underlying marrow suppression or malignancy. –.

11/ When should you call Hematology urgently for thrombocytopenia?. Here’s when to act fast, and why:. – TTP.Thrombocytopenia + hemolysis ± confusion, renal failure, fever. → Send ADAMTS13 and Call Heme STAT. → Plasma exchange removes autoantibodies and supplies missing.

10/ On the other hand -. Thrombocytopenia on the Wards: Think Slow, Think Chronic. When you encounter thrombocytopenia on the general medicine floor, the approach changes. It’s *often* not an acute emergency. It’s a chronic or subacute process until proven otherwise. What should.

9/ Thrombocytopenia in the ICU: A Different Beast. Platelets drop in critically ill patients all the time. Common culprits:. – Sepsis and DIC.– Mechanical destruction (ECMO, IABP).– HIT (especially post-op or post-CVICU).– Cytokine storm/inflammation-driven consumption.–.

8/ What labs should you send when platelets are low?. – CBC with differential.Helps assess for other cytopenias. – Peripheral smear.Look for schistocytes, blasts, platelet clumping, or large platelets. The smear will often narrow your differential immediately. – LDH,.

7/ Once you’ve confirmed true thrombocytopenia, your next question is simple:. Is this an emergency?. Key questions to ask:. – Is the patient actively bleeding?.– Are platelets critically low? (Usually <10k–20k).– Are there other cell lines affected? (Anemia, leukopenia?).– Are.

6/ Now that you’ve confirmed it’s real, time to think about true thrombocytopenia. When platelets are low, causes fall into three main categories:. – Decreased production:.Bone marrow isn’t making enough platelets. → Causes: chemotherapy, radiation, alcohol use, viral.

5/ Other causes of falsely low Platelets:. – Clotted sample.→ Blood started clotting in the tube.→ Platelets trapped in the clot.→ Result: falsely low platelet count. – Large platelets (giant platelets).→ Machine misses them or misclassifies as white cells.→ Result: falsely.

4/ Thrombocytopenia doesn’t always mean true thrombocytopenia. Ask:. – Has the platelet count been repeated?.– Was the blood drawn properly?.– Did the lab report platelet clumping (Pseudothrombocytopenia)?. Pseudothrombocytopenia is caused by EDTA-dependent platelet clumping in